Adherence to antiviral treatment among people living with chronic hepatitis B: A global survey

doi:10.5501/wjv.v14.i4.110951

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 14, Issue 4

This Article

Academic Content and Language Evaluation of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (16)

All Articles published online

The chart showing PDF series, HTML series, Tables (1-4) series.

Item

Count

PDF

HTML

Tables (1-4)

Sum=25

Featured Article

The chart showing Browse series, Download series.

Item

Count

Browse

Download

Sum=0

Publishing Process of This Article

Item

Count

Browse

Download

Sum=0

Dec 25, 2025 (publication date) through Dec 25, 2025

Times Cited of This Article

Times Cited (0)

Journal Information of This Article

Publication Name

World Journal of Virology

ISSN

2220-3249

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

World J Virol. Dec 25, 2025; 14(4): 110951
Published online Dec 25, 2025. doi: 10.5501/wjv.v14.i4.110951

Adherence to antiviral treatment among people living with chronic hepatitis B: A global survey

Suzanne J Block, Yasmin Ibrahim, Chari Cohen

Suzanne J Block, Department of Health, Behavior and Society Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States

Yasmin Ibrahim, Chari Cohen, Hepatitis B Foundation, Doylestown, PA 18902, United States

Author contributions: Cohen C and Ibrahim Y conceptualized, administered, and obtained funding for the original study; Block SJ and Ibrahim Y prepared the draft for this manuscript, coded and analyzed the data; Block SJ, Ibrahim Y, and Cohen C reviewed the original draft and interpreted data to provide feedback on the draft manuscript. All authors contributed to the article and approved the final submitted version.

Institutional review board statement: The study that included collecting this data was Institutional Review Board approved by Heartland Institutional Review Board (No. 191221-270). Participation in the survey was voluntary and anonymous.

Informed consent statement: Not applicable. No individual identifying data has been collected. Survey responses were all anonymous.

Conflict-of-interest statement: The Hepatitis B Foundation receives public health program and research grants from Bristol-Myers Squibb Company, GSK plc, Gilead Sciences, Inc., Dynavax Technologies, F. Hoffmann-La Roche Ltd., Vir Biotechnology, Inc., and Precision Biosciences, Inc. Chari Cohen serves on a patient advocacy advisory committee for GSK plc and Gilead Sciences, Inc., with remuneration going directly to the Hepatitis B Foundation. Ibrahim Y serves on a patient/advocacy advisory committee for F. Hoffmann-La Roche Ltd./Genentech, with funds being distributed to the Hepatitis B Foundation. Block S is supported by the training grant T32 CA009314 from the National Cancer Institute, National Institutes of Health. The content of this work is solely the responsibility of the author and does not necessarily represent the official views of the National Institutes of Health.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: Please contact the corresponding author for data requests. Data is available upon reasonable request.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Suzanne J Block, RN, BSN, MPH, Department of Health, Behavior and Society Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, United States. sblock8@jhmi.edu

Received: June 19, 2025
Revised: September 12, 2025
Accepted: December 2, 2025
Published online: December 25, 2025
Processing time: 189 Days and 17.8 Hours

Abstract

BACKGROUND

Current antiviral treatment for chronic hepatitis B can suppress viral replication and reduce the risk of cirrhosis and liver cancer. It requires lifelong daily medication, and long-term adherence is often cited as a concern when initiating treatment. Hepatitis B treatment adherence in the context of the patient’s medical and life experiences remains underexplored.

AIM

To evaluate factors associated with adherence to hepatitis B oral antiviral treatment.

METHODS

A global online survey was administered anonymously to adults (aged 18 years or older) living with chronic hepatitis B. A subsample of 614 individuals who reported being on hepatitis B treatment was included in the analysis. Indices for treatment affordability, healthcare service acceptability, and individual physical, psychological, and emotional functioning were constructed (Cronbach’s alpha = 0.71-0.83). Data analysis was conducted using Stata/BE 17.0.

RESULTS

Overall, 81% of respondents reported high adherence to hepatitis B treatment. Lower adherence was observed among individuals who identified as African or African American (P = 0.008). Among participants with low adherence, 60% cited affordability as a challenge (P = 0.068), 53% identified healthcare service acceptability as a challenge (P = 0.04), 79% described physical functioning as a challenge (P = 0.002), and 40.5% reported difficulties with psychological functioning (P = 0.55).

CONCLUSION

Findings demonstrate high treatment adherence, although access to and acceptability of healthcare services, as well as an individual’s physical functioning challenges, appear to be related to low adherence.

Keywords: Chronic hepatitis B; Adherence; Antiviral treatment; Accessibility; Affordability

Core Tip: As we work towards global hepatitis B elimination, it is essential to understand how individuals’ medical and psychosocial dimensions of care influence treatment adherence. Overall findings from this study demonstrate high treatment adherence among participants living with hepatitis B. However, access to and acceptability of healthcare services, as well as an individual’s physical functioning challenges, appear to be related to low adherence. This study adds new data and can inform future treatment guidelines to better align with patients’ lived experiences and support effective programmatic strategies aimed at optimizing treatment adherence and improving health outcomes for people living with hepatitis B worldwide.